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Title: Characteristics of patients with cardiogenic shock complicating acute coronary syndrome and its influence on clinical outcomes.
Author: Noaman, S.
Andrianopoulos, N.
Brennan, A.
Reid, C.
Stub, D.
Biswas, S.
Walton A.
Clark, D.
Ajani, A.
Freeman, M.
Shaw, J.
Oqueli, Ernesto
Yip, T.
Duffy, S.
Chan, W.
Issue Date: 2019
Conference Name: 67th Cardiac Society of Australia and New Zealand Annual Scientific Meeting, the International Society for Heart Research Australasian Section Annual Scientific Meeting and the 13th Annual Australia and New Zealand Endovascular Therapies Meeting.
Conference Date: August 8th-11th
Conference Place: Adelaide, Australia
Abstract: Background : Cardiogenic shock (CS) complicates ∼5% of patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI), with the highest mortality in certain subgroups despite contemporary ACS treatment. Methods: Patients with ACS enrolled in the Melbourne Interventional Group registry (2005–2013) with CS ( n = 636) were analysed according to pre-specified subgroups. Those with STEMI were compared to non-STEMI, and multivessel PCI compared to single-vessel PCI. Short-term MACE (death, MI, target-vessel revascularisation) and long-term National Death Index (NDI)-linked mortality were assessed between the subgroups. Results: Patients with CS presented with high rates of STEMI (89%) and a preponderance of multivessel disease (70%), however, only 12% underwent multivessel PCI. In-hospital and 30-day MACE were high in the CS cohort (46% and 47% respectively). Long-term NDI-linked mortality was 51% in the entire CS cohort. Subgroup analyses revealed greater in-hospital, 30-day and NDI-linked mortality among those who presented with non-STEMI compared to those with STEMI (63% vs. 38%, 64% vs. 38%, and 79% vs. 47%, respectively, all p < 0.01). There was a trend towards higher in-hospital and 30-day mortality among those who underwent multivessel PCI (50% vs. 39%, p = 0.07 and 50% vs. 40%, p = 0.09). Higher long-term NDI-linked mortality was observed in the multivessel PCI subgroup (63% vs. 49%, p < 0.05). Conclusion: Cardiogenic shock complicating ACS portends very poor short and long-term survival with particularly high mortality in the non-STEMI and multivessel PCI subgroups.
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Internal ID Number: 01373
Type: Conference
Appears in Collections:Research Output

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